Susto: a soul wrenching fright

Neuroanthropologist Daniel Lende alerted me to this short video of an Ecuadorian healer or curandera treating a condition called ‘susto‘.

‘Susto’ literally means ‘fright’ in Spanish but the patient is not simply assumed to be suffering from shock or anxiety as the fright is thought to have caused the soul to leave the body which, in turn, causes a range of psychological and physical symptoms.

The anthropologist Arthur Rubel, who was one of the first to study the condition in detail, examined a range of cases and drew up a short list of its symptoms that included: “(1) during sleep the patient evidences restlessness; (2) during waking hours patients are characterized by listlessness, loss of appetite, disinterest in dress and personal hygiene, loss of strength, depression, and introversion”.

However, as an influential study by Michel Tousignant noted that other anthropologists have given remarkably different definitions, including fever, muscular pains, complexion changes, nausea, vertigo, and stomach or intestinal upsets; the inability to carry out your normal social role; an emotional crisis related to love or sexual problems, or, in the highlands of Ecuador, a problem that normally effects children that can lead to death if unchecked.

This last definition seems to be exactly what is being treated in the video as in the last few frames you can see a whole row of children being attended by curanderos and the video is labelled as taken in the highland Ecuadorian city of Cuenca.

The American Psychiatric Association’s DSM defines ‘susto’ as a culture-bound syndrome which is supposed to be a non-universal syndrome which only occurs in a specific culture but actually means a syndrome that only appears in foreign cultures as the category seems to automatically exclude a diagnosis if it appears in Americans.

Although its tempting to classify the condition as a form of mental illness, Tousignant’s work makes clear that this is misguided as the condition is defined as primarily spiritual in nature with what we would call ‘symptoms’ being knock-on effects.

It would like be a bit like trying to define poverty as a mental illness. While you can see that it causes mental stress, defining it as a psychiatric disorder doesn’t make much sense because it is best understood as an economic concept.

The same applies to ‘susto’. You cannot define it as a mental illness, as the DSM tries, without stripping it of its meaning from the cultures in which it appears.